David V Condoluci, D.O.

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

MB42223 Issued in NJ

Practice address

709 Haddonfield Berlin Rd
Voorhees, NJ 08043-3715

Phone

(856) 566-3190

Fax

(856) 783-2193

NPI assigned

Jan 23, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kennedy Medical Group Practice, P.C.

  • Family Medicine Physician
  • Voorhees, NJ
  • NPI 1952726796
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485993600000",
    "number": "1245210459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 HADDONFIELD BERLIN RD",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080433715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 HADDONFIELD BERLIN RD",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080433715",
            "telephone_number": "856-566-3190",
            "fax_number": "856-783-2193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDOLUCI",
        "first_name": "DAVID",
        "middle_name": "V",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2017-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NJ",
            "license": "MB42223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "440000826",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "748404",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Compassionate and Supportive Counseling
• Complete Care at Kresson View LLC
• Complete Care at Voorhees LLC
• Comprehensive Cancer & Hematology Specialists, P.C.
• Comprehensive Family Dentistry
• Mark Condoluci, D.O.
• Rachel Conti, DPT
• Continuum Home Healthcare LLC
• Joshua William Cook, PHARMD
• Lauren Coombs

• Infectious Disease Physician in Voorhees, NJ
• Providers in Voorhees, NJ by specialty
• Infectious Disease Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.